Pawing Around with Pet Insurance

What is pet insurance?

Pet insurance is a way to plan for the unexpected. Dealing with pet accidents or illnesses are traumatic enough. Coupled with the thought of how you’re going to pay for unexpected pet care can make these situations extremely stressful. In many cases, pet owners have to make medical decisions based on what they can afford. Pet insurance offers peace of mind and helps alleviate financial anxieties in times when you want to focus on offering the best veterinary care for your pets.

How does pet insurance work?

In short, pet insurance plans are reimbursement plans for covered medical expenses. You are responsible for paying your pet’s vet bill then submitting a claim form to the insurance company for reimbursement. The coverage, deductible, and reimbursement amount depends on the company and specific policy you choose.

After your pet’s appointment, ask us for an itemized copy of your receipt. You will send it to your insurance company with a completed claim form. (We’ll also happily process this paperwork and send it to the insurance company if you bring the claim form to your appointment.) Unlike human health insurance and HMOs, pet insurance companies work independently from veterinary practices, meaning you can choose any veterinarian, specialist, or emergency care provider.1

Pet Insurance Terminology

Trying to sort out the various insurance companies, plans, and best options for your pet may seem daunting and a bit confusing if you’re not well-versed in insurance-speak. Before we dig in deeper, let’s take a moment to review some insurance terms. This is an amended list from caninejournal.com. Check out their site for more terms and other great articles related to pet insurance.

Claim – The formal request to the insurance company asking for payment based on the terms of your policy. Claim forms are submitted for each incident with an itemized copy of the veterinary bill.

Premiums – The rate charged by the insurance company for active coverage (usually paid monthly or annually). Premiums are usually based on factors such as the specific plan chosen, geographic area, and breed/age of pet.

Deductible – Portion of the veterinary bill that you pay to the insurance company before you are eligible for reimbursement. Depending on the company, the deductible is either paid per incident or per year.

Co-Payment (co-pay) – The amount of money you pay per incident after (or in addition to) your deductible. The co-pay is usually listed as a percentage. For example, in an 80/20 plan, the insurance company pays 80% of the balance after your deductible is paid and you pay the remaining 20%. (You will be reimbursed 80% of the vet bill after deductible is met).

In many plans, premiums and deductibles can be adjusted by the pet owner to fit individual needs; higher deductibles result in lower premiums and vice versa. (The more you spend on the deductible, the less you spend on the monthly premiums.) For a great explanation of this, visit Trupanion Pet Insurance’s Website. Embrace Pet Insurance’s website also has a great explanation of deductibles, reimbursement amounts, and co-pays. Here, they also break down the difference between per-incident and annual deductibles and provide sample claims for each.

Pre-existing conditions – Any illness, accident, or medical condition your pet was diagnosed with before being covered by their policy or during the waiting period. Every major insurance company excludes pre-existing conditions from their coverage, however, the definition of a pre-existing condition or the length of time for a condition to be considered pre-existing varies with each company.

Exclusions – Items that are not included in your policy. Every plan is different but some exclusions include pre-existing conditions, hereditary disorders, breed-specific disorders, intentional injuries, and cosmetic procedures.

Because pet insurance is intended to reimburse pet owners for unforeseen veterinary fees, the most common types of pet insurance covers accidents and illnesses:

Accident Coverage: Coverage for veterinary treatment for unexpected injuries. Accident coverage is the most common and is offered by all companies, regardless of the pet’s age. Accident-only coverage tends to be much cheaper than accident and illness Policies because they do not cover costly sicknesses.

Illness Coverage: Coverage to treat sicknesses and disease. With most companies, illness coverage becomes more expensive as your pets age; this is an important reason to consider getting pet insurance when your pets are at their youngest age possible.

Some companies offer add-on wellness coverage to pay for expected annual or semi-annual care like routine checkups, bloodwork, and dental cleanings. Some companies, like Trupanion, do not offer wellness coverage at all as they believe this care should be planned and budgeted expenses by responsible pet owners. (They also claim it helps them keep their premiums low by not offering this coverage.) Sometimes, the annual cost of adding wellness coverage is more than if you paid for these services out of pocket, so be sure to do the math before purchasing. While we agree that routine care should be planned and budgeted for, it’s really a personal preference on how to do it. By either saving for routine care or getting wellness insurance coverage, it’s important to be financially prepared so you can confidently provide your furry friends with annual wellness care.

Do you own research and get multiple quotes before choosing a plan. A great resource for comparing the leading pet insurers, getting free quotes, and reading reviews from real customers is petinsurancereview.com . We highly recommend getting quotes from several companies to see how each compares for your pet’s breed, age, our geographic location, etc.

Understand premiums. Find out how your premiums are determined (species, breed, age, geographic location) and how and when your premiums may increase.

Understand pay-out limits. Different companies have caps to the amount of money they pay (May be an annual or lifetime limit or per incident limit). If there’s a maximum payout cap on the total reimbursement allowed for a year, it could limit the number of conditions that may be covered, which will affect the reimbursement amount.

Read the term and conditions of the insurance plan. Make sure you understand all of the requirements and exclusions listed in the policy.

Exclusions? Here is a list of the most common items not covered in pet insurance policies.

Anything that relates in any way to your pet’s medical history before the policy started (pre-existing conditions). Do not wait to purchase insurance until after your pet has an accident or illness as it will not be covered.

Anything related to pregnancy and/or birth

Routine, preventative, or planned treatments such as flea, tick, and worm preventatives, vaccinations, grooming, spay/neuters, etc. (Unless a part of the add-on wellness coverage as discussed above)

What is the waiting period? Most policies have a specified amount of time that must pass before coverage can begin. Claims made during the waiting period (even for unforeseeable emergencies) will not be covered. Waiting periods are used to prevent fraud.

Now that we’ve gone over the basics, let’s review and compare a few pet insurance companies – Embrace, Pets Best, Pet Plan, and Trupanion. We’ve chosen these companies in particular because we (or our clients) have had positive experiences with them.

Embrace offers one plan to cover against unexpected accidents or illnesses:

The plan can be customized allowing you to choose your annual premium, deductible and reimbursement percentages. Reimbursement percentages range from 65 – 90% of vet bill. (You’ll have a co-pay of 10%, 20%, or 35% after deductible is met).

A “Wellness Rewards” plan is also available to help budget for routine care. According to Embrace, Wellness Rewards is not insurance (no deductible, co-pay, or waiting period), but more like a flexible health savings account that can be added to any pet insurance policy.

Like Embrace, Pets Best offers accident and illness coverage with the option to add-on a wellness care plan for an extra premium.

Also like Embrace, the coverage includes hereditary conditions, diagnostics, cancer treatments, acupuncture and rehab. Most plans also cover the exam fee, chronic conditions, full coverage regardless of pet being spay/neutered, no upper age limits, and pregnancies (some breeds excluded).

They offer specialized accident-only plans for those on a limited budget. This plans covers things like broken legs, snake bites, and accidental swallowing, but does not cover medical issues such as illness or cancer.

Owners have flexibility when choosing reimbursement and deductible amounts. Reimbursement pay-outs range from 70-100% of vet bill (You’ll have a co-pay between 0 – 30% after deductible is met.)

The silver and gold plans include non-medical related items such as boarding kennel fees, advertising and reward for lost pets, vacation cancellation, and death benefits.

Depending on the plan chosen, reimbursement amounts range from 80-100% of vet bill. (You’ll have a co-pay of 0%, 10%, or 20% after deductible is met.)

Pet Plan says one distinguishing feature of their plan is full coverage for all hereditary and chronic conditions with no pay-out or time limits per condition.

They do not offer wellness coverage.

Like Embrace, Trupanion offers one comprehensive plan to cover against accidents and illnesses.

The plan covers diagnostics, surgeries, medications, treatments, and hospital stays if pet is sick or injured; Chronic and hereditary conditions are covered.

The plan covers 90% actual veterinary costs associated with an accident or illness. Exam fees associated with accident/illness are not covered. You pay deductible and remaining 10% of bill.

For a summary of the above plans, download and print a copy of our pet insurance comparison chart or ask us for more information. If anyone has any experience with the above companies or other pet insurance companies, let us know!